Schrod L, Frauendienst-Egger G, von Stockhausen H B, Kirschfink M
Department of Paediatrics, University of Würzburg, Federal Republic of Germany.
Eur J Pediatr. 1992 Sep;151(9):688-92. doi: 10.1007/BF01957575.
Recent clinical studies with adult polytrauma patients indicate that elevated plasma levels of anaphylatoxin C3a correlate with the subsequent development of the adult respiratory distress syndrome (ARDS). However, there are no parameters which allow a reliable diagnosis of ARDS in neonates. As the most predisposing condition for ARDS seems to be shock, plasma C3a was determined in 30 ventilated premature infants and neonates with respiratory distress syndrome (birth weights 660-3350 g) within the first 24 h post partum or 6-24 h after acute asphyxia or shock during the neonatal period. The range of C3a, measured by ELISA, was between 57 and 1000 ng/ml. In the asphyxia group (n = 15) peak levels of C3a in plasma (mean 388 ng/ml) were significantly higher (P less than 0.001) than in the control group (mean 153 ng/ml). In some neonates with suspected ARDS, additional samples were taken. A rise in C3a between days 2 and 8 was associated with a fatal outcome of the disease. As in adults, C3a might be a useful indicator for ARDS in neonates.
近期针对成年多发伤患者的临床研究表明，过敏毒素C3a的血浆水平升高与随后发生的成人呼吸窘迫综合征（ARDS）相关。然而，尚无参数可用于可靠诊断新生儿的ARDS。由于ARDS最主要的诱发因素似乎是休克，因此对30例患有呼吸窘迫综合征（出生体重660 - 3350克）的通气早产婴儿和新生儿在产后头24小时内或新生儿期急性窒息或休克后6 - 24小时测定了血浆C3a。通过ELISA测定的C3a范围为57至1000 ng/ml。在窒息组（n = 15）中，血浆C3a的峰值水平（平均388 ng/ml）显著高于对照组（平均153 ng/ml）（P < 0.001）。在一些疑似ARDS的新生儿中，还采集了额外的样本。第2天至第8天C3a升高与疾病的致命结局相关。与成人一样，C3a可能是新生儿ARDS的一个有用指标。
